1. Brief Report: Weight Gain Following ART Initiation in ART-Naïve People Living With HIV in the Current Treatment Era
- Author
-
Ruderman, Stephanie A, Crane, Heidi M, Nance, Robin M, Whitney, Bridget M, Harding, Barbara N, Mayer, Kenneth H, Moore, Richard D, Eron, Joseph J, Geng, Elvin, Mathews, William C, Rodriguez, B, Willig, Amanda L, Burkholder, Greer A, Lindström, Sara, Wood, Brian R, Collier, Ann C, Vannappagari, Vani, Henegar, Cassidy, Van Wyk, Jean, Curtis, Lloyd, Saag, Michael S, Kitahata, Mari M, and Delaney, Joseph AC
- Subjects
Cyclopropanes ,Adult ,Male ,integrase strand transfer inhibitors ,Pyridones ,Anti-HIV Agents ,Clinical Trials and Supportive Activities ,antiretroviral therapy ,Clinical Sciences ,HIV Infections ,Weight Gain ,3-Ring ,Piperazines ,Heterocyclic Compounds ,Clinical Research ,Virology ,Oxazines ,Humans ,HIV Integrase Inhibitors ,Tenofovir ,Alanine ,bictegravir ,Prevention ,Evaluation of treatments and therapeutic interventions ,HIV ,weight ,Middle Aged ,Dideoxynucleosides ,Benzoxazines ,dolutegravir ,Infectious Diseases ,Good Health and Well Being ,Anti-Retroviral Agents ,Alkynes ,6.1 Pharmaceuticals ,Public Health and Health Services ,HIV/AIDS ,Female - Abstract
ObjectivesEvaluate differences in weight change by regimen among people living with HIV (PLWH) initiating antiretroviral therapy (ART) in the current era.MethodsBetween 2012 and 2019, 3232 ART-naïve PLWH initiated ≥3-drug ART regimens in 8 Centers for AIDS Research Network of Integrated Clinical Systems sites. We estimated weight change by regimen for 11 regimens in the immediate (first 6 months) and extended (all follow-up on initial regimen) periods using linear mixed models adjusted for time on regimen, interaction between time and regimen, age, sex, race/ethnicity, hepatitis B/C coinfection, nadir CD4, smoking, diabetes, antipsychotic medication, and site. We included more recently approved regimens [eg, with tenofovir alafenamide fumarate (TAF)] only in the immediate period analyses to ensure comparable follow-up time.ResultsMean follow-up was 1.9 years on initial ART regimen. In comparison to efavirenz/tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC), initiating bictegravir/TAF/FTC {3.9 kg [95% confidence interval (CI): 2.2 to 5.5]} and dolutegravir/TAF/FTC [4.4 kg (95% CI: 2.1 to 6.6)] were associated with the greatest weight gain in the immediate period, followed by darunavir/TDF/FTC [3.7 kg (95% CI: 2.1 to 5.2)] and dolutegravir/TDF/FTC [2.6 kg (95% CI: 1.3 to 3.9)]. In the extended period, compared with efavirenz/TDF/FTC, initiating darunavir/TDF/FTC was associated with a 1.0 kg (95% CI: 0.5 to 1.5) per 6-months greater weight gain, whereas dolutegravir/abacavir/FTC was associated with a 0.6-kg (95% CI: 0.3 to 0.9) and dolutegravir/TDF/FTC was associated with a 0.6-kg (95% CI: 0.1 to 1.1) per 6-months greater gain. Weight gain on dolutegravir/abacavir/FTC and darunavir/TDF/FTC was significantly greater than that for several integrase inhibitor-based regimens.ConclusionsThere is heterogeneity between regimens in weight gain following ART initiation among previously ART-naïve PLWH; we observed greater gain among PLWH taking newer integrase strand transfer inhibitors (DTG, BIC) and DRV-based regimens.
- Published
- 2021